Granulomatous slack skin‐like clinical findings in Sézary syndrome

Granulomatous slack skin ( GSS ) is a very rare condition that has been described as a variant of mycosis fungoides. It is characterized by the development of bulky and pendulous skin folds in flexural areas that are histologically formed by atypical T lymphocytes, histiocytes and giant cells. We report the case of a 37‐year‐old African‐American female with history of Sézary syndrome (SS) that while on treatment for the disease and in a space of 1 month developed exorbitant slack folds in the axillae and cervical area mimicking GSS . The absence of giant cells and epithelioid granulomas in the biopsy ruled out this diagnosis. We report this peculiar SS presentation that clinically resembles GSS , but with histopathology that does not show the typical features of this condition. We also review the literature in regard to SS , GSS and granulomatous mycosis fungoides ( GMF ), particularly the existing criteria to differentiate these various entities.